What are the symptoms of ulcerative colitis?
The most common symptom is a series of attacks and bloody diarrhea that vary in severity and duration from one person to another and from one attack to another. They may start suddenly or gradually and may occur as frequently as 10 or 15 times in 24 hours. The attacks are often accompanied by pain and spasms around the anus (tenesmus). Attacks may also cause fever, loss of appetite, and weight loss.
With mild attacks, the symptoms are less alarming. The patient may feel tired, but usually, there are no signs of generalized illness.
The symptoms usually disappear between attacks, although some patients may suffer from mild chronic diarrhea.
Can ulcerative colitis cause complications?
Yes. The most serious complications are associated with a sudden attack of bloody diarrhea, perforation of the intestine, peritonitis, and intestinal bleeding.
Persons with ulcerative colitis may also develop anemia, arthritis, inflammation of the eyes, or tender nodules under the skin. If ulcerative colitis persists for longer than about 10 years, there is a greater than average chance of developing cancer of the colon.
How is ulcerative colitis diagnosed and treated?
A positive diagnosis may require an internal examination of the colon and a barium enema x-ray.
Mild attacks of ulcerative colitis are usually treated with antidiarrheal drugs, a low-fiber diet, and rest. Sulfonamide drugs may control the symptoms of a severe attack. Treatment with corticosteroids may also be necessary.
Persons who suffer an extremely severe attack may require hospital treatment. If complications develop, such as peritonitis or intestinal bleeding, emergency surgery may be necessary.
The outcome of ulcerative colitis is variable. However, most patients suffer repeated attacks over many years, and about 30 percent eventually require some form of surgery.
Patients with recurrent ulcerative colitis should have regular internal examinations of the colon to check for early signs of intestinal cancer. In most cases, it eventually is necessary to remove the colon (colectomy). The function of the anal sphincter can be preserved with a pouch procedure, and a permanent colostomy can usually be avoided.